2012 community benefit plan - Community Hospital of the Monterey

Transcription

Community Hospital of the Monterey Peninsula
2012 COMMUNITY BENEFIT PLAN
APRIL 2013 Dedicated to identifying and meeting the changing healthcare needs of the people
of the Monterey Peninsula and surrounding communities.
Prepared by:
Community Hospital of the Monterey Peninsula
A subsidiary of Community Hospital Foundation
P.O. Box HH, Monterey, CA 93942
Steven Packer, M.D., President/CEO
Frank C. Amato, Chair, Board of Trustees
Cynthia Peck, Vice President
(831) 625-4528 ❚ Fax (831) 625-4948
CONTACT:
Executive Summary
This community benefit plan for the fiscal year ending December 31, 2012,
describes Community Hospital of the Monterey Peninsula’s benefit planning process, the
benefits provided, and the economic value of those benefits. Community benefit services
are free or subsidized programs and services provided to meet identified community
needs and to serve the public interest. The plan both satisfies the requirements and
reflects the spirit of California’s community benefit legislation, SB 697. It documents
organizational leadership, partnerships with other community organizations, and
services to meet the needs of at-risk populations in the community.
Report Organization
The report is organized to address all the information suggested in the state’s
“Checklist for Hospital Community Benefit Plan,” issued April 2000.
 Section 1 documents organizational commitment and participation, including
board and hospital staff participation and community involvement. It describes
the ways in which the hospital presents the community benefit plan to the public
and describes our charity-care policy and non-quantifiable benefits. Appendix A
contains a copy of the hospital’s charity-care policy. Appendix B contains a copy
of the hospital’s community benefit program guidelines.
 Section 2 describes the communities served and summarizes the hospital’s
community partners by type of organization. Appendix C lists the specific
collaborating organizations.
 Section 3 summarizes the status of community assessment activities and priority
needs identified in the assessment.
 Section 4 summarizes the number of provided services by legislative category
and links them to identified community needs.
 Section 5 summarizes the value of benefits provided by legislative category and
links these dollars to identified community needs. Costs for charity care and
unpaid costs of public programs (government payer shortfalls) are reported
separately. The principal measure for monitoring community benefit services is
the dollar value of benefits returned to the community per dollar of tax exemption
value received.
 Section 6 Describes measurable objectives, outcome measurement methods,
and results.
i
Summary of 2012 Community Benefits
The community benefit planning process identified 132 benefit services for the
current year; these represent an economic value of $158.4 million. Of these dollars,
27.4 percent ($43.4 million) specifically serve the economically disadvantaged.
Thirty-four hospital departments were active in providing community benefit
services, often working in partnership with various community organizations. In addition,
the hospital collaborated with a total of 145 organizations in community benefit activities.
The economic value of savings from tax-exempt status was $19,718,631. Thus,
the hospital returned $8.03 in community benefits for each $1.00 saved because of taxexempt status.
Hospital cost of community benefits
Value of tax exemption
Community benefits per dollar of tax
exemption value
SB 697 Category
Medical care: vulnerable populations
Traditional charity care, at cost
Unpaid cost of Medi-Cal program
Medical care: broader community
Unpaid cost of Medicare program
Unpaid cost of other government programs
Negative-margin services
Other benefits:
Broader community and vulnerable populations
Health research, education, and training
Total benefits
$158,427,890
$ 19,718,631
$8.03
Dollars
$12,828,582
$30,560,076
$71,543,305
$11,288,699
$14,563,323
$14,590,313
$3,053,592
$158,427,890
In addition to the $158.4 million in quantifiable community benefit services, board
members, physicians, employees, and volunteers reported contributing 24,540 hours of
volunteer service to the community.
A summary of benefit services and volunteer hours by community need/focus
area is on the following page. The summary shows percentages of total benefit dollars
and services.
ii
Summary of Community Benefits by Community Need/Focus Area
Benefit Dollars
Total
Benefit Services
Percentage
Total
Percentage
Volunteer
Hours
Community Focus Area
Building Healthy Communities
$1,228,239
0.8%
18
13.6%
9,018
Health Education and Wellness
$2,573,615
1.6%
75
56.8%
2,687
$153,889,827
97.1%
19
14.4%
7,007
$736,209
0.5%
20
15.2%
5,828
All Benefit Services $158,427,890
100.0%
132
100.0%
24,540
Improving Access to Care
Special Care for Special Needs
iii
TABLE OF CONTENTS
SECTION 1
MISSION AND COMMITMENT ................................................................... 1-1
MISSION, VISION, AND GUIDING PRINCIPLES ...................................................................................... 1-1
ORGANIZATIONAL COMMITMENT ........................................................................................................ 1-3
ORGANIZATIONAL PARTICIPATION ..................................................................................................... 1-8
COMMUNITY BENEFIT PLAN RESPONSIBILITY ..................................................................................... 1-9
SECTION 2
COMMUNITY AND COLLABORATION ...................................................... 2-1
COMMUNITY SERVED ........................................................................................................................ 2-1
TARGET GROUPS ............................................................................................................................. 2-1
COLLABORATIONS ............................................................................................................................ 2-2
SECTION 3
COMMUNITY ASSESSMENT ..................................................................... 3-1
PHYSICIAN MANPOWER ASSESSMENT AND ACTION ............................................................................ 3-1
OTHER HOSPITAL-DRIVEN ASSESSMENT ACTIVITIES .......................................................................... 3-2
SECTION 4
BENEFIT SERVICES .................................................................................. 4-1
BENEFITS DATA COLLECTION ............................................................................................................ 4-1
BENEFIT SERVICE TABULATIONS ....................................................................................................... 4-1
SERVICES BY SB 697 CATEGORY ..................................................................................................... 4-2
COMMUNITY BENEFIT FUND GRANTS................................................................................................. 4-4
SECTION 5
VALUE OF BENEFIT SERVICES................................................................ 5-1
COST-BASED VALUE DEFINITIONS ..................................................................................................... 5-1
VALUE BY SB 697 CATEGORY ........................................................................................................... 5-1
VALUE BY FOCUS AREA (COMMUNITY NEED) ..................................................................................... 5-2
VOLUNTEER HOURS ......................................................................................................................... 5-3
EVALUATING THE ECONOMIC VALUE .................................................................................................. 5-3
COMPARISON WITH PRIOR YEAR ....................................................................................................... 5-4
SECTION 6
MEASURABLE OBJECTIVES ..................................................................... 6-1
SCOPE OF SERVICES ........................................................................................................................ 6-1
CLASSES AND SUPPORT GROUPS ..................................................................................................... 6-1
HEALTH FAIRS AND SCREENING EVENTS ........................................................................................... 6-3
Appendix A. Charity-Care Policy ....................................................................................................A-1
Appendix B. Community Benefit Guidelines ...................................................................................B-1
Appendix C. Community Benefit Collaborators ............................................................................. C-1
Appendix D. Alphabetical Master List of Services ......................................................................... D-1
1-0
Section 1
Mission and Commitment
This section describes the mission, vision, and values guiding Community Hospital of the
Monterey Peninsula (Community Hospital) in its commitment to benefiting the communities it serves.
It summarizes key elements of organizational commitment and participation in community benefit
programs. It concludes with an overview of organizational responsibility for benefit planning.
Mission, Vision, and Guiding Principles
Community Hospital is a nonprofit, integrated healthcare delivery system serving the residents
of the Monterey Peninsula and surrounding communities. Community Hospital is a subsidiary of
Community Hospital Foundation, a tax-exempt, nonprofit corporation which also owns other
healthcare-related entities. The hospital, established in 1934, is an active, caring member of the
community that provides compassionate, high-quality healthcare services at a competitive cost. Our
board-approved statement gives emphasis to commitment to the community and its vulnerable
populations. The board most recently reaffirmed the mission statement on March 5, 2009, and its
commitment to and policy governing community benefit services on April 4, 2012.
Mission Statement
Community Hospital of the Monterey Peninsula is dedicated to identifying and
meeting the changing healthcare needs of the people of the Monterey Peninsula and
surrounding communities.
We are committed to providing high-quality services at a competitive cost and
within a safe environment.
We provide educational and public service programs to enhance the health of our
community and the competence of those who provide the service.
We care for all who come through our doors, regardless of ability to pay, to the
fullest extent allowed by law and available resources.
The hospital’s guiding principles and vision statement also emphasize commitment to
community service by stressing community collaboration, hospital leadership, and quality healthcare
services. Our mission, vision, and guiding principles are the basis for all our community benefit
program decisions.
1-1
Guiding Principles
Patients come first. Their individual satisfaction with our services is the best measure of
our success. In every decision, seek to meet their needs above all others.
Our employees, medical staff, and volunteers are our most important organizational
resources. Recognize and develop each person’s contribution to the organization. Value
the diversity of those whose experiences, cultures, and abilities make up the hospital
family and our community.
Broad community participation in our programs is essential. Cultivate thoughtful and
active governance, dedicated volunteers, involvement in program planning and
assessment, and enlightened philanthropy.
An atmosphere of support and openness encourages innovation. Promote the free
exchange of ideas at all levels of our organization.
Quality can be continually improved in an atmosphere of support and openness.
Strive to improve service quality by assessing and improving governance, managerial,
clinical, and support processes that most affect patient outcomes. Promote the free
exchange of ideas and interdisciplinary communication as critical means to this end.
Reward full participation in the improvement of our organizational performance.
Quality care must be affordable. Through the prudent application of resources, deliver
excellent programs and services that represent a good value for our healthcare
consumers.
Be a significant, positive force in our community. Provide quality services to improve
the health of our community and the competence of those who provide healthcare
services; become personally involved in community affairs.
Caring is as important to quality healthcare as technology. Empower patients and
their families to participate in their healthcare by being sensitive to their experiences,
privacy, and dignity.
Facilities and policies should be designed to enhance the healing process. Both
should be periodically expanded and updated to meet the growing needs of the
community.
We are committed to preserving and enhancing the environment. Our purchasing,
operational, and disposal practices must contribute to the long-term health and viability of
our beautiful region.
We provide financial resources sufficient to meet the present and future healthcare
needs of our community.
1-2
Guiding Principles (Continued)
Responsibility and honesty are essential. We require the highest standards of ethical
behavior, not only of ourselves, but of our colleagues.
Do the right thing. Compliance with all applicable laws and regulations is a cornerstone of our
duty to ourselves, our patients, and those with whom we work.
Vision Statement
Community Hospital of the Monterey Peninsula will be the healthcare organization in our region
most concerned for those we serve, most chosen for the quality and value of our service, and
most respected for the integrity, competency, and commitment of our employees, medical staff,
and volunteers.
Organizational Commitment
The depth, breadth, and significant economic value of the benefit services described in this
benefit plan, and those of preceding years, demonstrate our strong commitment to community benefit
services. Community Hospital’s leadership of and participation in hospital-driven and collaborative
community needs assessment activities and our investment of time and resources in an objectiveoriented benefit planning system also show our commitment to community benefit services and the
spirit of SB 697.
Strategic Planning
The hospital’s most recent strategic plan, adopted by the Board of Trustees in February 2013,
supports the hospital’s continuing commitment to community leadership and benefit services in its
strategic intents and initiatives. Initiatives are selected for implementation on the basis of community
needs assessment activities.
1-3
Community Benefit-Related Strategic Plan Goals (excerpts)
Strategic Intent #3 — Employee and Community Health: CHOMP will lead the promotion of
evidence-based health and wellness for our community.
Related Strategic Initiatives:
• Expand CHOMP’s proven employee wellness and disease management strategies for
diabetes, hypertension, coronary artery disease, and/or lipid management for a total of at least
seven health plans or employers.
•
Expand CHOMP’s employee health and wellness programs to include value-based insurance
design features to our employee wellness discount program.
Strategic Intent #4 — Physician Alignment:
CHOMP will be a leader in promoting, integrating, and facilitating physician service to our entire
community and the adoption of evidenced-based, best-practice clinical care. Together with our
medical staff leadership, we will proactively address the critical strategic issues of patient access,
physician recruitment, leadership development, physician satisfaction, clinical decision support, and
information sharing (e.g., coordinated electronic medical records).
Related Strategic Initiatives:
•
Improve access to primary care and specialty physicians in demonstrated-need categories by
recruiting at least ten new physicians to the community this year.
•
Preserve access to existing primary care and specialty physicians in our community through
innovative ways to keep their practices sustainable.
•
Develop and deploy the patient-centered medical home care model in existing primary care
practices.
Strategic Intent #7 — Value-Based Care: CHOMP will be the leader in the development of valuebased care models. These models will embrace the concept of integrated population management
and will utilize innovative, risk-based, incentive-driven financing models.
Related Strategic Initiative:
•
Develop and launch a locally owned and operated self-insured health insurance product to
improve access to affordable health insurance for our community.
1-4
Charity Care
Policy and Funding: To help meet the needs of low-income and uninsured or underinsured
patients, Community Hospital has been providing care for community residents, without regard to their
ability to pay, since the organization was founded. Effective January 1, 2007, the sponsored care and
discount program also meets the requirements of AB 774. Funding for the program is provided by
philanthropic contributions and through the hospital’s operating budget. The program grants
sponsored (charity) care and/or discounted care solely based on a person’s financial need, regardless
of age, sex, race, national origin, physical or mental disability, sexual orientation, religion, color,
ancestry, marital status, citizenship, medical condition, or veteran status. Patients may apply for
assistance before receiving hospital services or after the hospital provides the care. (Appendix A
contains a copy of the policy in effect during 2012.)
Implementation and Procedures: The Patient Business Services and Social Services
departments screen applicants for the sponsored care and discount programs. Completed
applications, including required documentation, are submitted to Patient Business Services or Social
Services for initial review and follow up. The patient/responsible party, and/or service department are
notified of the final eligibility decision in writing. Should there be any dispute as to the decision made
by the hospital on the eligibility or level of eligibility of the patient for either the sponsored care or
discount payment program, an appeal of the decision may be made to the director of Patient Business
Services.
In 2012, the income limit for sponsored care was 250 percent of the federal poverty guidelines,
and the income limit for the discount program was 350 percent of the federal poverty guidelines (these
parameters were last updated in 2007). The hospital follows the requirements of AB774 in all
respects.
Communication to Patients and the Community: Each patient receives a guide for patients and
visitors while in the hospital. This guide describes the sponsored care and discount programs and
directs application inquiries to the appropriate department. In addition, Community Hospital publicly
displays information on the general program in key service locations and provides information to every
patient at the time of registration for services and enclosed with billing statements. Information on
specialty programs (e.g., free baseline mammography through the Sherry Cockle Fund and
rehabilitation services through the Thomas A. Work, Jr., Fund) are provided to patients who register
for these specific services.
Through its public web site, Community Hospital also publicizes the sponsored care and
discount programs and illustrates the benefits of the program. A formal presentation about hospital
billing practices and sponsored care requirements is provided to community groups on request by our
Patient Business Services department.
Non-Quantified Community Benefits
Community Hospital is the sole acute-care provider in its primary service area and a vital
member of the Monterey Peninsula community. It enhances the health and well-being of the
community in a variety of ways not quantified in this community benefit plan. The hospital is the
1-5
largest private employer on the Monterey Peninsula, with approximately 1,947 employees and an
annual payroll, including benefits, of $242 million in 2012.
The hospital’s mission has always guided its decisions and policies to improve the overall
health of community residents, improve access to health services, and address unmet health needs.
Beginning in 1955, trustees voted to build a new facility on 22 acres of donated land to replace an
outdated facility which had been serving the community since 1934. Gifts from the community
financed two-thirds of the cost of this new facility. This partnership and community generosity have
continued and allowed the hospital to purchase new equipment and upgrade facilities in response to
changing community needs.
The purchase of Eskaton Monterey Hospital in 1982 allowed Community Hospital to merge the
two acute-care facilities. Consumers continue to receive the benefit of the significant operating
efficiencies produced by the merger, with hospital charges (average charge per stay) that consistently
rank in the lowest quartile for comparable hospitals in Northern California. In response to community
need, Community Hospital later converted the former Eskaton Monterey Hospital to the Hartnell
Professional Center, a major center for outpatient services. The Recovery Center, a chemicaldependency treatment program for both teens and adults, and Behavioral Health Services, which
offers outpatient mental health services, are among the services now located there.
The hospital established an outpatient surgery center in 1987 and expanded its Rehabilitation
Services facility in 1992. A new Family Birth Center opened in 1996, offering single-room maternity
care. Acquisition and integration of Hospice of the Central Coast and Westland House (formerly called
Hospice House) into Community Hospital occurred in 1997, and the Comprehensive Cancer Center
facility opened in late 1999.
Community Hospital’s Carol Hatton Breast Care Center opened in 2002, in direct response to
community requests and following input from local women’s organizations. The latest digital screening
and diagnostic tools are available to patients under one roof at the center. The center is the most
innovative and comprehensive center for the prevention, diagnosis, treatment, and recovery of breast
cancer and breast disease on the Central Coast, and the only center in the region to have achieve
Center of Excellence designation from the American College of Radiology.
Anticipating the wider community’s future growth taking place in Marina, Ft. Ord, Seaside, and
along the Highway 68 corridor, in 2004 the hospital opened the expansive, centrally located Ryan
Ranch Outpatient Campus which houses an expanded Sleep Disorders Center, Diabetes and
Nutrition Therapy programs, an outpatient imaging center, an additional satellite lab, a health resource
library, doctors’ offices, and administrative offices for the hospital’s hospice program and education
department.
Three factors drove the decision to develop the Ryan Ranch facility. First, the hospital has
provided various outpatient services at the main hospital that could be provided at greater patient
convenience outside the inpatient facility. Second, the hospital had offered services in some 16
different locations across the Peninsula and in Salinas, some of which could be coordinated on a
single campus. Finally, Community Hospital has a long history of growing in the direction, both
geographically and medically, of its community.
In 2005, the hospital opened a new cardiac catheterization laboratory to help meet the growing
local need for treatment for heart disease, the number-one cause of death for both men and women.
1-6
The final phase of construction of the Pavilions Project concluded in 2012. The first phase,
which included larger operating rooms to accommodate a cardiac surgery program as well as
upgraded critical-care facilities, opened in late 2006. The second phase, which added a new inpatient
wing with 120 private rooms (for a net bed increase of approximately 32 beds, as older units were
taken out of service) opened in early 2007. The final phase of the project involved renovation of
existing hospital facilities, and was completed in several sub-phases. The first group of services to
open in expanded facilities included diagnostic and interventional radiology services, cardiac and
pulmonary diagnostic services, the cardiac catheterization laboratory (including the addition of an
electrophysiology laboratory), an inpatient rehabilitation gym, and an expanded pharmacy. The
significant investment in the Pavilions Project will allow the hospital to meet growing community
demand for hospital services.
In 2011, Community Hospital’s multi-facility Marina campus opened to help address a wide
array of unmet needs of the residents of that and surrounding communities. The campus includes
Peninsula Wellness Center (an integrated medical fitness facility designed to help those at risk for and
those facing health challenges reduce their risk and improve their health and wellness); a second
location for Peninsula Primary Care (providing local residents with access to primary care physicians);
outpatient physical, occupational, and speech therapy services; cardiac and pulmonary rehabilitation
programs; and satellite laboratory and radiology facilities. In addition, the campus also includes a
second location for Monterey Bay Urgent Care, a local physician-owned service in which Community
Hospital owns a minority interest.
In 2013, Community Hospital plans to open a new Inpatient Rehabilitation Unit (IRU) in the
main hospital. This new service, providing aggressive physical, occupational, and speech therapy in
an inpatient setting, was developed in direct response to the unmet need for this service in the local
area. Following an internal study, the hospital discovered that the vast majority of patients leaving its
acute-care facility who could benefit from this level of post-acute care did not receive it anywhere,
largely because of the challenges of families traveling daily to distant locations to participate in the
patients’ care. When the new IRU is opened, we expect that more people in our community will be
able to achieve the significant functional improvement required to live as independently as possible
following a disabling injury or illness.
Community Benefit Fund Grants
The hospital’s community benefit program includes a significant annual commitment of funds
available for grants to nonprofit organizations and multi-agency collaborative organizations in support
of health assessment and improvement projects within our service area. Community Hospital gives
higher priority to projects that involve collaboration among organizations and make appropriate use of
Community Hospital’s clinical expertise. Grants are awarded under the community benefit program
objectives of building healthy communities, health education and wellness, improving access to care,
and providing special care for special needs.
The program’s overall priorities and funding are reviewed and approved by the Board of
Trustees annually, and grant decisions are made by the President’s Administrative Committee. Grant
applications are welcome at any time. See Appendix B for the complete description of the grant
program.
1-7
In 2012, Community Hospital awarded a total of $237,245 in 20 grants to 17
organizations.
Organizational Participation
Board Participation: The Board of Trustees gives overall leadership to the community benefit
process by establishing the mission and strategic goals of the hospital. The board approves the
community benefit plan annually, including the program’s own mission, scope, and grantmaking
guidelines.
Board members serve as ambassadors to the community, serve on board committees, and
provide governance to the hospital, the foundation (the hospital’s tax-exempt parent corporation), and
related entities. As residents of the Monterey Peninsula, they are advocates for community needs and
encourage active participation of the hospital and its employees and medical staff in meeting those
needs.
Staff Participation: Staff participation begins with an ongoing community benefit inventory to
identify community benefit services. Staff works with management in developing mission-driven
community benefit activities and in planning appropriate changes in existing services as well as new
services. Department directors and their staffs manage and implement essentially all community
benefit services, including formulating objectives, collecting data, and providing cost and related data
for the community benefit plan.
The following is an overview of the roles of several key departments in community benefit
planning and implementation:
 The hospital’s community health committee is an interdisciplinary group responsible for
planning and coordinating our health education programs and activities, including those for
hospital staff, patients, and community members. Beginning in 2013, this committee is also
responsible for conducting the needs assessment and recommending the development of
programs to meet identified needs.
 Administration, coordinated by a vice president, monitors progress on needs assessment
activities and the community benefit program in relation to the strategic plan, as well as
oversees the grantmaking program.
 Financial Services oversees the data collection process and produces aggregate reports for
the community benefit plan.
 Administration and Financial Services prepare the annual community benefit plan for Board of
Trustees review and approval.
 Communication and Marketing prepares community reports on the hospital’s community
benefit program including segments in the hospital’s annual report (3,791 copies distributed),
Pulse magazine (27,264 households; 2 issues per year), and large ads in local newspapers.
Physician Participation: Physicians contribute through leadership of and participation in
community benefit activities. In addition to the chief of staff, there is a designated physician seat on
the Board of Trustees. Physicians actively participate in hospital and community programs, in
1-8
collaborative relationships with Community Hospital and other providers, and through involvement in
medical staff committees such as the Community Health Committee. Several medical staff
committees are directly involved in planning mission-driven community benefit activities. Physicians
also provide numerous hours of volunteer work within the community.
Community Benefit Plan Responsibility
The ultimate responsibility and oversight for the implementation of the community benefit plan
resides with the Board of Trustees, President’s Administrative Committee (senior executives), and
mid-level management (department heads) of Community Hospital of the Monterey Peninsula.
1-9
Section 2
Community and Collaboration
Community Served
Community Hospital’s primary service area is the Monterey Peninsula, health facility planning
area (HFPA) #707. The Monterey Peninsula includes Carmel, Carmel Valley, Del Rey Oaks, Marina,
Monterey, Pacific Grove, Pebble Beach, Sand City, Seaside, Big Sur, and unincorporated areas of
Monterey County (see service area map).
Factors used in defining the community for community benefit planning purposes include:
1. Community reliance on Community Hospital’s services — the hospital’s market share of
Peninsula resident discharges was approximately 79 percent in 2012.
2. Hospital reliance on the community — residents of the Peninsula accounted for approximately
78 percent of the hospital’s patients in 2012.
3. Community benefit history and collaborative relationships with community organizations.
4. Desires and perspectives of community groups with which the hospital collaborates.
The socioeconomic characteristics of the Monterey Peninsula span a broad spectrum. Carmel
and Pebble Beach are relatively affluent communities with substantial retired and senior populations.
Big Sur and other unincorporated parts of the County are largely rural in character. The communities
surrounding the former Fort Ord army base (Seaside, Marina, and Sand City) are less affluent and
continuing to grow, with a younger population, more children, and significant racial and ethnic
diversity. In spite of the socioeconomic variations, the Monterey Peninsula is a distinct sub-region of
Monterey County with a well-defined sense of community.
Target Groups
The seven target groups within the service area identified for community benefit planning are:







Children/Youth
Women
Men
Seniors
Economically disadvantaged
Community subgroups, e.g., military, students, ethnic populations
General community
A description of the distribution of benefit services and dollars among these target groups is in
Sections 5 and 6.
2-1
Collaborations
Since launching our community benefit program, Community Hospital has collaborated with
the community on both community assessment and community benefit service activities, including
through our grantmaking program and the extensive community involvement of our staff and
physicians.
Benefit service collaborations involved 145 local organizations in 2012. The following is a
summary of collaborating organizations by type. Appendix C contains a listing of collaborating
organizations for community benefit activities.
Collaborating Organizations
Community Benefit Activities
Type of Organization
Number of Organizations
Business Organizations
Community Groups
Educational Organizations
Healthcare Organizations
Public Agencies
Total Collaborators
21
26
39
35
24
145
2-2
SERVICE AREA MAP
2-3
Section 3
Community Assessment
Community Hospital continues to be guided by a number of community assessment efforts to
measure unmet needs and improve health outcomes. This section describes community assessment
methods, results, and future directions.
Physician Manpower Assessment and Action
Since 1999, Community Hospital has engaged in periodic assessment of the adequacy of
physician resources needed to meet community healthcare needs. The first study demonstrated that
there were unmet needs in certain physician specialties, and that the problem would likely worsen
over the next several years. Because the shortages did, in fact, worsen in the intervening years, the
Board of Trustees established a formal physician recruitment program in 2001 to provide significant
financial support and a more aggressive organizational commitment to meeting these community
needs and improving access to care for local residents.
The physician recruitment program includes ongoing assessment of the changing needs and
demographics of the hospital’s service area, changing market conditions, and active medical staff
demographics and practice patterns. The program is regularly updated to reflect this assessment data
(as well as changes in applicable laws governing such programs), and recruitment priorities are
established annually by hospital administration and medical staff leadership. The program is designed
to provide the assistance necessary to bring physicians in specialties with demonstrated local
shortages to the hospital’s primary service area.
Through 2012, the hospital had successfully recruited 66 physicians to the Monterey
Peninsula under the program. All are required to participate in the Medicare, Medi-Cal, and
CHAMPUS/TriCare programs, because the shortage of physicians on the Monterey Peninsula willing
to do so is particularly acute.
Current recruitment priorities include:
• adult primary care (family/internal medicine and hospitalists)
• cardiology
• endocrinology (inpatient diabetology expertise)
• pulmonary medicine/critical care
• general and vascular surgery
• infectious disease
• neurology (stroke and inpatient neurology expertise)
• obstetrics/gynecology
• pediatrics
• physical medicine and rehabilitation (inpatient expertise)
• psychiatry
• urology
Because the shortage of primary care physicians is the most acute physician manpower issue
and unmet healthcare need facing the hospital’s community, in 2008 the Board of Trustees took
official action to create Peninsula Primary Care, a new nonprofit subsidiary of Community Hospital
Foundation.
3-1
Peninsula Primary Care (PPC) opened its initial site at the Crossroads in Carmel in September
2009. This site was selected to help address a significant unmet need among the Medicare population
in that community. A second site opened in 2011 in Marina. Not only is this community underserved in
primary care, but Marina residents also visit an emergency room at a much higher rate than residents
of other local communities. As a result, the site includes an urgent care center as well as radiology
and laboratory services.
The goal is to recruit additional physicians to practice in our community, as well as provide a
stable practice environment for some existing physicians to prevent their leaving the community. We
anticipate that each PPC site will require an annual subsidy from Community Hospital of
approximately $1 million when fully operational.
Other Hospital-Driven Assessment Activities
In 2010, Community Hospital completed an updated and comprehensive assessment of our
community’s unmet healthcare needs. Professional Research Consultants (PRC) was retained to
conduct a statistically valid telephone survey of 1,000 randomly selected local adults. The survey was
based largely on the Centers for Disease Control and Prevention behavioral risk factor surveillance
system. In addition, we collected and analyzed secondary data from national, state, and local sources
such as incidence rates of disease, causes of death, etc. All of the data was then compiled and
benchmarked against the goals of the national Healthy People 2010 initiative sponsored by the U.S.
Department of Health and Human Services.
The analysis of this assessment revealed that existing Community Hospital community benefit
services continue to be appropriately directed, but also pointed out potential opportunities to bring
greater emphasis to services targeted at obesity and other limitations on physical activity, in addition
to three major opportunities described below.
Residents of the Community Hospital service area are failing to meet Healthy People 2020
goals for such foundational health elements as blood pressure screening, high cholesterol, and
diabetes deaths (among others). This finding has, in part, led the organization to develop a medical
fitness facility in Marina which will provide health assessment, screening, and education, as well as
medically supervised exercise programs to assist members in improving their health status and in
managing chronic conditions. Services and programs are being designed to meet the needs of
residents who are obese and/or face other limitations on their physician activity by providing a safe
and welcoming environment for those just beginning to address their health issues. The facility
opened in 2011.
The complex healthcare needs of the most vulnerable local residents have also led to the
launch of a major new initiative aimed at improving the health status and reducing the need for
hospitalization by this population. In late 2011, Community Hospital established a new nonprofit
subsidiary, Community Health Innovations, to guide and support area primary care physician
practices in implementing the medical home model of care and to support physicians throughout our
community in effectively using and sharing electronic health information, and eventually to implement
integrated population management strategies. A significant investment is being made in these
programs.
Another key finding of the assessment was the higher prevalence of stroke and the higher rate
of death from stroke in the local population, when compared to Healthy People 2020 goals. In 2009,
Community Hospital became the first Joint Commission-certified primary stroke center in Monterey
County and launched an active public education campaign regarding the risk factors for stroke as well
3-2
as the importance of recognizing and seeking immediate treatment for the signs of stroke. The quality
of care for local stroke patients has improved demonstrably as a result of this successful initiative.
Finally, the updated community needs assessment revealed that access to affordable health
insurance has become an even more critical local issue due to the prevailing economic conditions. In
2011, Community Hospital launched a locally owned and operated self-insured health insurance
product to improve access to affordable health insurance for our community. And in 2014, Community
Hospital will launch a Medicare Advantage insurance plan in Monterey County, offering two types of
insurance policies for area Medicare recipients designed to offer affordable access to the traditional
healthcare services in our community in addition to the benefits of our disease management, primary
care medical home, and other integrated population management expertise.
The community assessment is next scheduled to be updated in 2013.
3-3
Section 4
Benefit Services
This section summarizes benefit activities by SB 697 category, community focus, community
need, and target group. A complete alphabetical master list of benefit services and descriptions is in
Appendix D.
Benefits Data Collection
Benefits data collection begins with an annual update of the hospital’s organization-wide
inventory of all community benefit activities. The person responsible for each identified benefit service
then completes a benefit data form for that service. Information provided includes the following:





Service title, description, and objectives
Target groups and community needs served
Collaborative partners
Occurrences and number of persons served
Staff and volunteer hours and costs
Lyon Software’s computer program, CBISA Online, serves as the primary data management
tool.
Benefit Service Tabulations
Each benefit service’s SB 697 category and hospital focus area are identified. The
CBISA Online program produces data for tables and cross-tabulations for the following categories.
 SB 697 category
 Target group
 Hospital focus area (community need)
The hospital has established focus areas that encompass community needs identified in the
community assessment, while reflecting its own community benefit program vision.
4-1
Services by SB 697 Category
The community benefit inventory for 2012 identified 132 community benefit services. The
distribution of these services as follows:
SB 697 Category
Medical care services
Other benefits: broader community
Other benefits: vulnerable populations
Total Services
Number of
Services
14
23
7
88
132
Services by Primary Target Group
Generally, more than one target group uses individual community benefit services. For
example, many services for seniors also serve women. The term “primary target group” designates
which group generally comprises the intended primary user group.
Primary Target Group
Children/youth
Women
Men
Seniors
Economically disadvantaged
Community: specific groups (a)
Community: general
Total Services
Number of
Services
10
5
1
3
12
42
59
132
(a) Specific groups include both demographic groups and disease-specific groups,
e.g., cancer patients.
Services by Focus Area (Community Need)
The distribution of community benefit services by Community Hospital focus area is as follows:
Number of
Services
18
75
19
20
132
Focus Areas
Building healthy communities
Health education and wellness
Improving access to care
Special care for special needs
Total Services
4-2
The five highest-cost benefit services for each of the focus areas are shown below.
Focus Areas:
Five Highest-Cost Benefit Services





Carpooling incentives/employee shuttle program
California Transplant Donor Network support
United Way employee campaign
Hand sanitizer distribution to promote infection prevention
Materials Management donation of supplies





Family and patient education and counseling
Web site resources
Pulse magazine
Scholarship program
Health news sponsorship
 Unpaid cost of Medicare services
 Unpaid cost of Medi-Cal services
 Negative-margin services
 General charity care (at cost)
 Unpaid cost of CHAMPUS services





Mental health information and referral services
Food donations to community
Bereavement program
Community benefit fund grants
Griefbusters
4-3
Health and Wellness Services by Type of Service
The distribution of health and wellness community-benefit services by type of service is as
follows:
Type of Service
Number of
Services
21
5
15
28
7
30
106
Health education classes
Health fairs/screenings
Information and presentations
Support groups
Training classes
Other
Total Services
Community Benefit Fund Grants
Grants are generally single-year commitments to support current or new programs consistent
with the mission of Community Hospital. Applications are reviewed and awards are made by the
hospital’s President’s Administrative Committee. Higher priority projects are those that involve
collaboration among organizations, make appropriate use of Community Hospital’s clinical expertise,
and improve access to care. In 2012, there were 20 grants that totaled of $237,245, with an average
amount of $11,862. The amount and number of grants for each of the four focus areas are listed
below:
Number of
Grants
Dollar
Amounts
6
$ 22,295
Health education and
wellness
6
51,250
1
75,000
7
88,700
20
$237,245
Focus Area
Total
4-4
Section 5
Value of Benefit Services
This section presents the dollar value of the community benefit services described in the
preceding section. It includes tabulations by SB 697 category and hospital-defined focus area, as well
as for staff and volunteer hours. The costs for charity care and government payer shortfall (i.e., unpaid
costs of public programs) are reported separately, as are costs by each target group.
Cost-Based Value Definitions
As prescribed by SB 697, community benefit dollars presented in this report include only free,
discounted, subsidized, or negative-margin services and the unpaid cost of public programs, less
funds received from fees and other sources. Unpaid costs of public programs are presented using the
hospital’s cost accounting data. No indirect cost is added to unpaid cost of public programs, negativemargin services, general charity, or overhead cost centers. Salaries include employee benefits.
Benefit Value versus Marketing Value
Community benefit activities are those with uncompensated cost and which address
community needs. Health education and wellness are the primary goals of most community benefit
programs. While some positive marketing value may occur, this document does not attempt to
separate benefit value and marketing value. Estimates of marketing value would be highly speculative
and non-informative, since there is no objective way to separate benefit and marketing values.
Value by SB 697 Category
SB 697 Category
Other benefits:
Broader community and vulnerable populations
Total benefits
Dollars
$12,828,582
$30,560,076
$71,543,305
$11,288,699
$14,563,323
$14,590,313
$3,053,592
$158,427,890
5-1
The five highest-value services for health research, education, and training and other benefits
are as follows:
Health Research, Education, and Training
Benefit
Family and patient education and counseling
Web site resources
Mental health information and referral services
Pulse magazine
Scholarship program
Amount
$493,214
$338,360
$262,621
$251,096
$196,995
Other Community Benefit Programs, Including Those Benefiting
Vulnerable Populations
Benefit
Physician recruitment program
Peninsula Primary Care
Free prescriptions for needy patients
California Transplant Donor Network support
Amount
$10,604,328
$715,353
$662,469
$410,257
$391,549
Value by Focus Area (Community Need)
The following is the dollar value of and number of services for each hospital-identified focus
area:
Focus Areas
Total benefits
Amount
$1,228,239
$2,573,615
$153,889,827
$736,209
$158,427,890
Number of
Services
18
75
19
20
132
The following is the percentage of dollars and services for each hospital-identified focus area:
Percent of
Dollars
0.8%
1.6%
97.1%
0.5%
100.0%
Focus Areas
Total
5-2
Percent of
Services
13.6%
56.8%
14.4%
15.2%
100.0%
Volunteer Hours
In addition to the 41,727 paid staff hours contributed toward community benefit services, board
members, physicians, hospital staff, and Auxiliary volunteers reported contributing another 24,540
volunteer hours. These individuals donate their personal time and effort with no reimbursement or
payment. Their personal contributions to community benefit activities are an indispensable component
of the hospital’s contribution and dedication to the community.
Focus Area
Total hours
Staff
Hours
8,413
12,653
14,703
5,958
41,727
Volunteer
Hours
9,018
2,687
7,007
5,828
24,540
Evaluating the Economic Value
One benchmark for evaluating the economic value of community benefit services provided is
the dollar value of the hospital’s tax-exempt status. A desirable community benefit dollar value
exceeds the value of tax-exemption. Elements included in calculating the value of tax-exempt status
include:




Interest rate differential on tax-exempt financing for long-term debt
Property tax on assessed value
State income tax obligation without tax exemption
Federal income tax obligation without tax exemption
The following table shows that Community Hospital returned to the community far more in
community benefits than the value of its tax exemption in 2012:
Hospital cost of community benefits
Value of tax exemption
Community benefits per dollar of tax
exemption value
5-3
$158,427,890
$ 19,718,631
$8.03
Comparison with Prior Year
The following table compares the value of community benefits for 2012 with the value for
2011:
2012
Net
Change
$11,454,505
19,875,163
$12,828,582
30,560,076
$ 1,374,077
10,684,913
73,324,351
8,710,485
12,838,765
71,543,305
11,288,699
14,563,323
-1,781,046
2,578,214
1,724,558
Other community benefits
16,143,847
14,590,313
-1,553,534
3,313,992
3,053,592
-260,400
$145,661,108
$158,427,890
$12,766,782
SB 697 Category
2011
Total quantified benefits
5-4
Section 6
Measurable Objectives
This section describes measurable objectives, the method for measuring outcomes for those
objectives, and the results for the year.
Scope of Services
The focus of measurable objectives and outcome measures is on health education and
wellness services provided in classroom and support-group settings and through the hospital’s
speakers’ bureau.
Health education and wellness services comprise 67 percent of benefit services for the year.
They are the principal venue for community outreach. In a primary service area of only 140,000
residents, 31,534 (more than 22 percent of service area residents, assuming no person participated in
multiple services) participated in educational classes and support groups alone.
Type of Service
Class
Health fair/screening
Speakers Bureau event
Support group
Training
Subtotal
Presentation
Other
Total
Number of
Services
21
5
2
28
7
63
13
30
106
Occurrences
112
24
58
96
10
300
(a)
(a)
---
Persons
Served
2,899
12,037
6,240
10,134
224
31,534
(a)
(a)
---
(a) Persons served and occurrences are difficult to quantify for these types of
services (e.g., radio spots and Web site inquiries).
Classes and Support Groups
General Objectives
The general objectives of the health education and wellness benefit services in classroom and
support-group settings are as follows:
6-1
 Healthful Behavioral Change: Assist participants toward more healthful behavior
through improved knowledge and skills.
 Convenience and Relevance: Provide the services in convenient settings with content
that meets participants’ perceived needs.
Measuring Outcomes
Standardized participant evaluation forms provide the data for measuring how well the
services meet the objectives. Participants complete forms at the conclusion of each class and support
group. Participant evaluation questions for each of the general objectives are as follows:
Healthful Behavioral Change:
 Was the information helpful?
 Did you learn a new skill?
 Will you change your lifestyle as a result of what you learned?
Convenience and Relevance:
 Were the time and location convenient?
 Did the instructor meet your needs?
 Would you recommend this class to others?
The hospital recognizes that participant “lifestyle-change” statements are often considered to
have a low reliability as an outcome measure. Lifestyle-change statements are, however, a good
indicator of whether or not the participant has absorbed and processed pertinent information and, in
the context of these community benefit services, appear to be best suited as a reporting mechanism.
Community Hospital health education classes, health fairs, support groups, and training
programs served 31,534 persons in 2012, at an average cost of $37.83 per participant. Compared to
the cost of providing the service, the cost of implementing more sophisticated outcome measures
(such as those involving pre- and post-testing and independent observations with follow-up surveys)
would be prohibitive.
Specific Objectives and Outcomes
For each of the questions, the participants have three choices, two positive (definitely and
somewhat) and one negative (not at all). Specific objectives were expressed in terms of the
percentage of positive responses of each of the questions. The following two tables show the specific
objectives and corresponding outcomes for 2012. In the aggregate, the outcomes more than meet the
specific objectives for all the questions.
6-2
SPECIFIC OBJECTIVES
Participant Evaluation Question
Percentage
Positive Response
Healthful Behavioral Change
Was the information helpful?
Did you learn a new skill?
100%
97%
Will you change your lifestyle as a result?
Convenience and Relevance
Were the time and location convenient?
Did the instructor meet your needs?
Would you recommend this service to others?
93%
99%
100%
100%
OUTCOMES FOR 2012
Percentage Positive
Responses
Support
Class
Group
Type of Service
Helpful Behavioral Change
Was the information helpful?
100%
100%
Did you learn a new skill?
98%
96%
Will you change your lifestyle as a result?
92%
95%
99%
100%
100%
100%
100%
100%
Convenience and Instructors
Were the time and location convenient?
Did the instructor meet your needs?
Would you recommend this service to others?
Health Fairs and Screening Events
Health fairs and screening events are community outreach services which offer education and
screening for specific health risks. In 2012, Community Hospital offered education, screening, and
tests for the following types of diseases and risks:








Blood glucose
Blood pressure
Carbon monoxide
Cholesterol
Infant/child safety
Peripheral vascular disease
Prostate cancer
Skin cancer
6-3
General Objectives
The general objectives of the health fairs and screening events are as follows:
 Risk Detection, Education, and Referral: Promote wellness through early detection
of risk, education of participants, and referral for appropriate healthcare follow-up.
Measuring Outcomes
The data compiled at health fairs and screening events to evaluate how well they meet their
objectives are as follows:
Early Risk Detection
 Number of participants
 Number of screenings
 Number of abnormal results
Education and Referral
 Follow-up and education on abnormal screening results outside normal range
 Advice on appropriate contact with family physician or healthcare resource
6-4
Specific Objectives and Outcomes
The following two tables show the specific objectives and corresponding outcomes for 2012.
SPECIFIC OBJECTIVES
Evaluation Measure
Objective
Number of participants
Number of screening tests
Within +/- 10% of prior year
At least 25% of participants
Percentage of abnormal results
Not applicable
Education and follow-up for abnormal results
100% of applicable tests (a)
Follow-up and referral
(a)
Tests sufficiently outside the normal range.
OUTCOMES FOR 2012
Evaluation Measure
Data Value
Specific Outcome
Number of participants
Number of screening tests
Number of abnormal results
4,037 (a)
2,151
444
Within +/- 17% of prior year
More than one screening per two
participants
21% abnormal results
Education and follow-up for abnormal results
Follow-up on abnormal results
(a)
444
100% of applicable tests
Excluding 8,000 for Big Sur Marathon and Half-Marathon Health Expos.
6-5
Appendix A. Charity-Care Policy
POLICY TITLE:
FINANCIAL ASSISTANCE PROGRAM
SPONSORED CARE & DISCOUNT
PAYMENT POLICY
ORIGINATING DEPARTMENT:
PATIENT BUSINESS SERVICES &
SOCIAL SERVICES
DISTRIBUTION:
SOCIAL SERVICES, PAC, SERVICE
DEPARTMENTS, PBS
POLICY NUMBER: POLADM5
ORIGINAL DATE:
LAST REVIEW DATE:
APPROVED BY PAC:
REVISION DATE:
NEXT REVIEW DATE:
12/01
11/10
4/12
4/14
POLICY STATEMENT
Community Hospital of the Monterey Peninsula strives to provide quality services in a caring
environment and to make a positive, measurable difference in the health of individuals we serve. Helping
to meet the needs of low-income uninsured and underinsured patients is an important component of our
commitment to the community.
The criteria Community Hospital of the Monterey Peninsula will follow in qualifying patients for
financial assistance programs are described in this policy. Upon approval, financial assistance is provided
through one of two programs: (1) the Sponsored Care Program; or (2) the Discount Payment Program.
These programs may cover all or part of the cost of services provided, depending on the patient's
eligibility, income and resultant ability to pay for services. The Sponsored Care and Discount Payment
Programs are intended for patients whose personal or family financial ability to meet hospital expenses is
absent or demonstrably restricted, and the benefits provided by the hospital under these programs inure to
the benefit of the patient. The minimum requirement for both programs is stated below and is based
upon the patient’s combined family income as a percent of the Federal Poverty Guidelines (FPL) that are
published annually in the Federal Register. http://aspe.hhs.gov/poverty . Given Community
Hospital of the Monterey Peninsula’s service area demographics, available resources and mission to meet
the healthcare needs of its community, financial assistance is available for patients with income levels up
to 350 percent of the FPL. Community Hospital’s Sponsored Care and Discount Payment Programs are
intended to fully comply with the Hospital Fair Pricing Policies Act. This policy is intended to be stated
as clearly and simply as possible for the benefit of our patients.
The hospital’s Sponsored Care Program provides uninsured or underinsured eligible patients with a
discount of up to 100% on medically necessary services provided by the hospital. To qualify for the
Sponsored Care Program the patient family’s gross income must not exceed 250% of the Federal Poverty
Level referred to above. In addition, to qualify for the Sponsored Care Program, the value of the patient’s
monetary assets must not exceed $110,000.
The Discount Payment Program establishes a discount to be applied to uninsured or underinsured patient
accounts and reduce patient liability to the payment amount the hospital would receive from the most
generous government sponsored health benefit program under which the hospital participates. Patients
with incomes at or below 350% of the Federal Poverty Guidelines may be eligible for the Discount
Payment Program.
Patients who are eligible for the Sponsored Care or Discount Payment Program may agree to a reasonable
payment plan and make monthly payments if they cannot pay their bill in a lump sum. Such payment
A-1
plans will be negotiated with the patient and will be interest free. However, the payment plan may be
terminated if the patient does not make all scheduled payments.
ELIGIBILITY AND SERVICES
Patients may be eligible for the Sponsored Care or Discount Payment Program if the following criteria are
met. Three classifications of patients may be eligible for participation in the Sponsored Care or Discount
Payment Program:
•
A self pay patient may be eligible for either the Sponsored Care or Discount
Payment Program if the patient does not have third party health insurance coverage, a
health care service plan, Medicare or MediCal, and whose injury is not a compensable
injury for purposes of workers’ compensation, automobile insurance, or any other
insurance that may cover the hospital services provided to the patient.
•
An insured patient may be eligible for the Discount Payment Program if the
patient has high medical costs and does not receive a discounted rate from the hospital
because of the patient’s insurance, provided the patient’s out of pocket medical
expenses in the 12 months before hospital services were provided exceed 10% of the
patient’s family income during the same 12 month period.
•
An insured patient may be eligible for the Sponsored Care Program if the patient’s
income and monetary assets meet the eligibility standards explained below and the patient has
any out of pocket medical expenses.
•
Documentation Requirements –
Income: As a condition of eligibility, patients are required to submit proof of their own and their
family members’ income. As a condition of eligibility, all applicants are required to submit tax
returns for the most recently completed calendar year or pay stubs for the last three months to
verify their own and their family members’ income. If the patient and/or family members do not
have income tax returns or pay stubs, the hospital may deny the application for Sponsored Care
and Discount Payment.
Monetary Assets: To qualify for the Sponsored Care program, patients are required to provide
documentation to establish the value of the patient’s monetary assets, in addition to
documentation regarding income. Monetary assets include cash, liquid assets, investments,
savings, gold, checking accounts, and certificates of deposit. Patients are required to provide bank
statements, brokerage account statements and other documentation to verify monetary assets.
Patients are not required to provide documentation of income from retirement plans or
deferred compensation plans.
High Medical Costs: Patients who apply for the Discount Payment Policy due to high medical
costs must provide bills, cancelled checks, statements, explanation of benefit documents, or other
documentation to prove the amount of the patient’s out of pocket medical expenses in the most
recent 12 months before hospital services were provided. If the patient pays his/her own
insurance premiums, these may be included as medical expenses during the 12 month period.
Such out of pocket expenses must amount to at least 10% of the reported family income for the
included 12 months.
The patient’s failure to provide documentation of income, assets, medical expenses, health
benefits coverage, family unit or other requested documentation or to apply for public or
private insurance in a timely manner as requested may result in denial of the patient’s
application for Sponsored Care and Discount Payment Program assistance.
A-2
•









Services - This policy applies only to medically necessary services provided by Community
Hospital on or after January 1, 2007. Services provided at the hospital by private health care
providers, such as personal physicians and ambulance conveyance, are not covered by this policy.
The Sponsored Care Program and Discount Payment Program are available for services provided
by Community Hospital that are not paid for by any federal, state, or county programs, entities
and/or funding sources, or third party insurance coverage for which an individual applicant is
eligible. The hospital may require an uninsured patient to apply for private or public health
insurance or sponsorship that may fully or partially cover the charges for care rendered by the
hospital, and will provide applications for or referral to these programs to the patient.
Services that are not covered include, but are not limited to:
All non-hospital billed services such as:
o Non-hospital based Physicians’ Services
o Ambulance transportation
Medications
Non-medically necessary bariatric surgery
Cosmetic services
Services for which, in the opinion of competent hospital staff, are provided only as a stop-gap
when a patient is staying at the hospital, or at Westland House, for the convenience of the family
and/or physician.
Non-medically indicated care.
Durable Medical Equipment
Oxygen and oxygen supplies
Any service or product considered to be experimental by the major payers; services or products
unapproved for patient use by the FDA; services or products the provision of which would
effectively place the hospital in the position of having to provide such services or products for
extended periods of time including when the patient is not a patient of Community Hospital.
• Application – Patients may apply for assistance under either the Discount Payment Program or
the Sponsored Care Program, or both programs. A patient who applies under both programs and
meets eligibility criteria for both programs will be approved for the benefit that is most favorable to
the patient. If a patient applies for the Sponsored Care Program, but is ineligible, the hospital will
review the application to determine if the patient is eligible for the Discount Payment Program.
Applications for the Sponsored Care or Discount Payment Program must be submitted to the hospital
within 120 days of the date services were provided, or within 90 days of payment made to the hospital
by third party coverage.
• Family- For purposes of the Sponsored Care Program and the Discount Payment Program,
“family” is defined as follows: For persons 18 years of age or older, family includes the patient’s
spouse, domestic partner and dependent children under 21 years of age, whether living at home or
not. For persons under 18 years of age, family includes the patient’s parent(s) or caretaker relatives
and other children of the parent(s) or caretaker relative who are under 21 years of age.
• Interest Free Payment Plans- Patients who are eligible for the Sponsored Care or Discount
Payment Program, and have a non-covered portion of their bill remaining, may agree to a reasonable
payment plan and make monthly payments if they cannot pay their bill in a lump sum. Such payment
plans will be negotiated with the patient and will be interest free. However, the hospital may
terminate the interest free payment plan if the patient does not timely make all scheduled payments.
A-3
Eligibility Criteria Applicable To the Sponsored Care Program
Financial Qualification- two classifications of patients may be eligible for participation in the Sponsored
Care Program:
1. A self pay patient who does not have third party health insurance coverage, a health care
service plan, Medicare or Medicaid, and whose injury is not a compensable injury for
purposes of workers’ compensation, automobile insurance, or any other insurance that may
cover the hospital services provided to the patient.
2. An insured patient whose income and monetary assets meet the eligibility standards
explained below and the patient has any out of pocket medical expenses.
Income – To qualify for the Sponsored Care Program the patient’s family gross income must not
exceed 250% of the current federal poverty level (FPL). The FPL is published annually and this policy is
updated by incorporating each subsequent edition of the FPL as an attachment.
Monetary Assets- For purposes of eligibility for the Sponsored Care Program, the value of the patient’s
monetary assets must not exceed $110,000 Monetary assets are defined as cash, liquid assets,
investments, savings, gold, checking accounts, and certificates of deposit. Monetary assets do not include
retirement or deferred compensation plans. When determining eligibility for the Sponsored Care
Program, the hospital will only consider 50% of the patient’s monetary assets over the first $10,000, (the
first $10,000 is not counted in determining the patient’s assets). After this calculation, if a patient’s net
monetary assets exceed $50,000, the patient is not eligible for the Sponsored Care Program.
The hospital may require waivers or releases from the patient or the patient's family, authorizing the
hospital to obtain account information from financial or commercial institutions, or other entities that hold
or maintain the monetary assets to verify their value.
Patients wishing to qualify for the Sponsored Care Program must apply for and comply with MediCal or
other state or county program requirements before being considered for Sponsored Care. This includes
spend down provisions that may be invoked in the qualification for county or state programs.
Eligibility Criteria Applicable To The Discount Payment Program
Financial Qualification- two classifications of patients may be eligible for participation in the Discount
Payment Program:
1. A self pay patient who does not have third party health insurance coverage, a health care service
plan, Medicare or Medicaid, and whose injury is not a compensable injury for purposes of
workers’ compensation, automobile insurance, or any other insurance that may cover the hospital
services provided to the patient. This includes VA patients who refuse to access VA facilities for
treatment, MIA Patients who refuse to access the county facility or any other likely payer.
2. An insured patient with high medical costs who does not receive a discounted rate from the
hospital because of the patient’s insurance, provided the patient’s out of pocket medical expenses
in the 12 months before hospital services were provided exceed 10% of the patient’s family
income during the same 12 month period. This includes self-paid health insurance premiums if
that coverage is used for care at Community Hospital.
Income – To qualify for the Discount Payment Program the patient’s family gross income must not
exceed 350% of the current federal poverty level (FPL). The FPL is published annually and this policy is
updated by incorporating each subsequent edition of the FPL as an attachment.
A-4
BENEFITS
Sponsored Care Program
•
•
•
•
The Sponsored Care Program provides eligible patients with up to a 100% discount on medical
services provided by the hospital. The discount is determined based on the patient’s income and
monetary assets and the amount of the hospital bill or the portion of the bill that remains unpaid
after receipt of payment by the patient’s insurer. The discount is described in this policy and on
the attached Matrix of Sponsored Care.
For example, a self pay patient with a gross family income at or below 150% of the federal
poverty level whose total hospital charges for medically necessary service would normally cost
more than $10,000 and who qualifies for the Sponsored Care Program will receive a 100%
discount, resulting in a bill of zero. An eligible self pay patient with a gross family income
between 201 and 250% of the federal poverty level will receive an 85% discount on the total
regular hospital charges for medically necessary services provided between $10,000 and $20,000.
An insured patient who is eligible for the Sponsored Care program and with a gross family
income at or below 150% of the federal poverty level who owes the hospital less than $5,001
after payment to the hospital by the patient’s insurance company will receive a 95% discount on
the portion of the bill due from the patient. An eligible insured patient with gross family income
between 200% and 250% of the federal poverty level who owes the hospital $10,500 after the
patient’s insurance company pays its share will receive an 85% discount on the patient’s portion
of the bill.
However, a patient who is eligible for the Sponsored Care Program will not be charged more than
the highest amount the hospital would receive for providing the services from the highest paying
government sponsored health benefit program in which the hospital participates. If the payment
received by the hospital from an insured patient’s insurance company exceeds the amount the
hospital would have received from the highest paying government sponsored health benefits
program, the patient will not be charged any additional amount for the medically necessary
services rendered.
Discount Payment Program
•
The Discount Payment Program provides eligible patients a discount on the cost of hospital
services.
Eligible patients will not be charged more than the highest amount the hospital would receive for
providing the services to a beneficiary of the highest paying government sponsored health benefit
program in which the hospital participates. Eligible insured patients with high medical costs will
be charged a maximum of the difference between the amount their insurance company pays for
services and the highest amount the hospital would receive for the services from a government
sponsored health benefit program. Patients who qualify for the Discount Payment Program will
be offered the opportunity to agree to interest free extended payment plans for any charges they
are unable to pay in a lump sum. Eligible patients must agree in writing to a payment plan within
120 days of receiving services from the hospital. Upon request, a payment plan will be
negotiated with each eligible patient, and will remain interest free only if the patient makes timely
payments in accordance with the terms of the payment plan. If the patient fails to make regularly
scheduled payments during any 90 day period, the hospital may terminate the payment plan, and
the entire unpaid balance will be due, together with interest that will accrue on the remaining
balance from the date of default at the maximum legal rate. If the patient defaults on any
payment, he/she may request that the payment plan be renegotiated.
Only the patient’s income and the patient’s family members’ income, as measured by income tax
records or pay stubs, will be requested or considered in determining eligibility for the Discount
Payment Program.
A-5
Sherry Cockle Fund
•
To qualify for services under the Sherry Cockle Fund, a breast care screening program, patients
must work in Monterey County and their treating physician must be practicing in Monterey
County. Sherry Cockle Fund approval does not require a Medi-Cal denial or financial
qualification.
PRACTICE
1. Current and prospective patients may apply for the Sponsored Care or the Discount Payment
Program. Information about these programs will be made available at all patient intake and
treatment points within Community Hospital facilities, and will be provided to each patient
presenting for services. An application for the Sponsored Care and Discount Payment Programs
will be provided to all patients who are interested. Additionally, information and applications (if
available) for State Medi-Cal, the Healthy Families Program, and any other available government
program will be provided to patients upon request and as required by law. A pre-screening
interview may be done with patients to ensure that they meet the basic eligibility criteria. Patients
will be referred to other available programs if appropriate, including Medi-Cal, the MIA program,
and Medicare SSI and other programs described on the attached list of programs and resources.
Assistance in applying for these and other Federal, State or County programs is available to any
interested patient. An eligible patient who is in the process of obtaining healthcare benefits from
a third party or government program may be granted Sponsored Care or Discount Payment
benefits under this policy while their application is pending. If the third party healthcare benefits
are granted, Patient Business Services will determine whether the coverage is retroactive to the
period covered by Sponsored Care or Discount Payment benefits and then file for claim coverage
and reverse the hospital’s Sponsored Care or Discount Payment award upon receipt of the third
party program payment.
2. Patients and prospective patients may request applications under any of the following
circumstances:
a) Prior to scheduling inpatient or outpatient services
b) While receiving recurring outpatient services;
c) During an inpatient stay. A Patient Access financial counselor will interview all self-pay
inpatients while in the hospital to determine the level of need and may assist the patient in
applying for assistance under this policy;
d) Up to 120 days following services or up to 90 days following payment of benefits to the
hospital due from a third party or parties.
The hospital’s Social Services Department reviews applications for Sponsored Care and Discount
Payment assistance prior to the provision of services if possible, and for ongoing post hospital
continuing care. Sponsored Care or Discount Payment Assistance, ER services, direct admits and
post services are reviewed by Patient Access and/or Patient Business Services. The reviewing
department verifies that an applicant meets basic eligibility criteria. If basic eligibility criteria are
not met, the applicant is not eligible for financial assistance through either the Sponsored Care or
Discount Payment Program. The responsibilities, in practice, for the reviewing department in
determining initial eligibility are as follows:
e) Determine that the patient is financially eligible using the eligibility criteria specified in
this policy.
f) Verify the most recent 12 months of family income. If the patient applies only for the
Discount Payment Program, only income information can be requested. The income
A-6
information that can be requested is limited to the patient’s and patient’s family
member’s tax returns or pay stubs. Income from line 22 of the federal tax return is
compared with the Federal Poverty Guidelines. If the patient is applying for sponsored
care and the line 22 income is below $10,000 the hospital may request documentation to
explain how the individual is living in this area with an income below $10,000 (e.g. other
sources of support, living circumstances, etc.). If these forms of documentation are not
available, or are not timely provided by the patient, the hospital may deny the application.
g) If the patient applies for Sponsored Care verify the patient’s assets in accordance with
this policy.
3. In support of an application for the Sponsored Care Program, the patient must also
identify and provide the value of the patient's assets. Monetary assets include
cash, liquid assets, investments, savings, gold, checking accounts, and certificates
of deposit. Monetary assets also include assets held in trust for the patient’s
benefit (including without limitation assets held in a "special needs trust") to
the extent such assets are currently payable to or for the benefit of the
patient, or may be payable to or for the benefit of the patient in the discretion
of the trustee. Patients are required to provide bank statements, brokerage
account statements and other documentation to verify monetary assets. Patients
are also required to provide a copy of any written trust documentation for a
trust which may hold assets includable as monetary assets hereunder, as well
as a current account or report describing the nature and value of such trust
assets. Patients are not required to provide documentation of income from
retirement plans or deferred compensation plans.
For purposes of eligibility for the Sponsored Care Program the value of the patient's
monetary assets must not exceed $110,000. Monetary assets are defined as cash, liquid
assets, investments, savings, gold, checking accounts, and certificates of deposit.
Monetary assets also include assets held in trust for the patient’s benefit (including
without limitation assets held in a "special needs trust") to the extent such assets are
currently payable to or for the benefit of the patient, or may be payable to or for the
benefit of the patient in the discretion of the trustee. Monetary assets do not include
retirement or deferred compensation plans. When determining eligibility for the
Sponsored Care Program, the hospital will only consider 50% of the patient's monetary
assets over the first $10,000 (the first $10,000 is not counted in determining the patient's
monetary assets). After this calculation, if a patient's net monetary assets exceed $50,000,
the patient is not eligible for the Sponsored Care Program.
The hospital may require waivers or releases from the patient or the patient's family, authorizing
the hospital to obtain account information from financial or commercial institutions, or other
entities that hold or maintain the monetary assets to verify their value.
Patients wishing to qualify for the Sponsored Care Program must apply for and comply with
MediCal or other state or county program requirements before being considered for Sponsored
Care. This includes spend down provisions that may be invoked in the qualification for county or
state programs.
If the patient is not eligible for the Sponsored Care Program because the patient’s monetary assets
exceed the allowable limit, or because the patient fails to timely provide requested documentation
in order to allow the hospital to verify the patient’s monetary assets, the application and the
patient and patient’s family’s income information will be reviewed to determine if the patient is
eligible for the Discount Payment Program.
A-7
4. Once the application is completed, the patient provides all requested documentation, and the
patient meets all eligibility standards, the application may be approved per the hospital’s
Approval Process described below.
5. Patients who were approved for financial assistance prior to January 1, 2007 under the hospital’s
financial assistance program may be required to apply for the Sponsored Care or Discount
Payment program, and provide documentation in support of their application.
6. Eligibility for the Sponsored Care or Discount Payment Program does not guarantee eligibility for
subsequent hospital services. Each application must be evaluated separately. However, a patient
may be presumptively eligible if they reapply for the Sponsored Care or Discount Payment
Program for hospital services provided within 120 days of a prior approval. For patients who are
receiving recurring services (daily, weekly, etc.) the 120 day reapplication requirement may be
waived and they may be required to reapply within one year from the date of approval of their
application, rather than every 120 days, as long as the recurring services are ongoing. However,
the hospital reserves the right to require the patient to reapply for the Sponsored Care or Discount
Payment Program and submit documentation in support of the application during the 120 day or
one year presumptive eligibility period. Beyond 120 days from completion of services a new
application will be required. Sponsored Care and Discount Program coverage for Behavioral
Health services will be limited to 30 visits per calendar year, following the limits of coverage
found in most insurance benefits packages, unless prior approval by the Director(s) of Behavioral
Health Services and Patient Business Services. Sponsored Care and Discount Program eligibility
for Recovery Center Services will be limited to a series of 3 extended treatment plans in a
lifetime. Failure to complete a treatment plan counts as one full treatment plan for the purpose of
this policy.
APPROVAL PROCESS
Pre-Service & Ongoing Hospital or Extra-hospital Services
1.
2.
3.
4.
Pre-Service Assistance is reviewed and administered/coordinated by the director of Social Services.
If appropriate Pre-Service Assistance is reviewed and signed by the Director of Patient Business
Services, Vice President, or President/CEO.
Final approval will not be given until approval signatures are obtained.
The patient/responsible party, and/or service department are notified of final approval in writing.
Approval Limits:
Cost of Services
Up to $1,000
Up to $5,000
Over $5,000
Approval Responsible Party
Social Services Staff
Director of Social Services (UR)
Director of Patient Business Services, Vice President or
CEO.
Post or Mid Hospital-based Services
1. Post or mid-service assistance is reviewed and determined by Patient Business Services, based on the
approval limits stated below.
2. If necessary, post or mid-service assistance is reviewed and determined by the Vice President/CFO.
3. Final approval will not be given until all approval signatures are obtained.
A-8
4. The patient/responsible party, and/or service department will be notified of final approval in writing.
Approval Limits:
Approval Responsible Party
Patient Business Services Representatives
up to $1,000.00
Patient Business Services Lead
$1,001.00 to $10,000.00
Patient Business Services Supervisor
$10,001.00 to $15,000.00
Assistant Director of Patient Business Services $15,001.00 to $25,000.00
Director of Patient Business Services
$25,000.00 to $50,000.00
Hospital Chief Financial Officer
$50,001.00 and above
Cost of Services
APPEAL AND DISPUTE RESOLUTION
Should there be any dispute as to the decision made by the hospital on the eligibility or level of
eligibility of the patient for either the Sponsored Care or Discount Payment Program, appeal of
the decision may be made to the Director of Patient Business Services. The patient must initiate
the appeal by submitting a written appeal within 30 days of the denial of the patient’s application
for Sponsored Care or Discount Payment. Patients are required to submit additional or different
information or documentation to substantiate the reason for the appeal.
The director will review the basis of the dispute or appeal and will render a decision in keeping
with the legal obligations of the hospital. Such decision will be given in writing within a
reasonable time of receipt of the appeal, usually within 10 working days following the receipt of
the patient’s Dispute or Appeal. The director’s decision will be final.
Refunds
Any amount collected from an eligible patient in excess of the amount due under the hospital’s
Sponsored Care or Discount Payment Policy will be refunded to the patient together with interest. Please
refer to the Patient Business Services Policy: POLCASH2: Refunds to Patients and Insurance for
interest rate and calculation information.
Other Programs/Resources Available To Patients
 Medi-Cal (Regular, Emergency, Pru-col)
 Medically Indigent Adult (MIA)
 Healthy Families
 CaliforniaKids
 Breast Cancer Early Detection Program (BCEDP) - mammograms
 Breast Cancer Cervical Cancer Treatment Program (BCCCTP) – mammograms & pap smears
 Impact (Prostate Cancer)
 PACT (Contraceptives/Contraceptive devices)
 Children’s Health & Disability Program CHDP – dental, vision, annual exam
 California Children Services CCS
 Access for Infants & Mothers AIM – maternity and infant care
A-9
Appendix B. Community Benefit Guidelines
Mission:
Community Hospital is committed to taking a leadership role in assessing and improving the
health status of the people in the communities we serve. Under the auspices of our Community
Benefit Program, we directly provide and financially support programs that achieve those
objectives.
We recognize that community health is as much a social, economic, and environmental issue as a
medical one and that no hospital or single provider can improve community health alone. In
addition to direct services provided throughout our healthcare system, we work in partnership
with other providers and award grants to support independent projects, particularly those which
involve collaboration among organizations.
Scope:
Community Hospital’s Community Benefit Program includes two primary elements:
1.
Direct Provision of Services
Community Hospital is a nonprofit, integrated healthcare delivery system providing
healthcare services from birth to end of life. Services include acute medical and surgical
care, skilled nursing care, emergency care, outpatient and home-based services, satellite
laboratories, mental health clinics, chemical dependency treatment, health education and
wellness programs, and hospice care. Many of these services are provided free or at very
low cost, and Sponsored Care is available for those in financial need.
2.
Community Benefit Fund
Community Hospital makes grants from the Community Benefit Fund to nonprofit
organizations and multi-agency collaborative organizations in support of health
assessment and improvement projects within our service area.
Community Hospital gives higher priority to projects that:
• increase access to healthcare for residents of our community (the highest priority);
• involve collaboration among organizations; and
• make appropriate use of Community Hospital’s clinical expertise.
Grants are awarded under the following Community Benefit Program objectives:
• Building Healthy Communities — assessing community health needs;
addressing the health-related goals identified by regional collaborative
organizations.
• Health Education and Wellness — improving the individual’s knowledge of
health risks and the impact of lifestyle choices on those risks; strengthening the
individual’s role in self-care and management of health and disease; early
detection of health problems; and enhancing the competence of healthcare
professionals.
B-1
•
•
Improving Access to Care — removing barriers to receiving healthcare services,
particularly primary care (currently the highest priority).
Special Care for Special Needs — meeting the physical and behavioral
healthcare needs of those at risk due to age, domestic or other violent crime,
chemical dependency, mental illness, HIV status, or socioeconomic status.
Grants from the Community Benefit Fund are generally single-year commitments from
$250 to $10,000 to support current or new programs consistent with the mission of
Community Hospital and our Community Benefit Program.
Community Hospital does not make grants to organizations that discriminate in the
hiring, advancement, or recruitment of employees or volunteers (including board
members) or in the provision of services on the basis of sex (including gender and gender
identity), race, religion, national origin, physical or mental disability, sexual orientation,
age, color, ancestry, marital status, pregnancy, citizenship, medical condition, veteran
status, or genetic information.
Community Hospital does not generally make grants to support individuals, capital
projects or endowment funds, or clinical research projects. Solicitation of Community
Hospital employees for contributions of money or time on behalf of grant recipients is
prohibited.
Grantmaking Process:
The Community Benefit Program, including program objectives and priorities, is reviewed and
approved by Community Hospital’s Board of Trustees annually. An annual Community Benefit
Plan is prepared in compliance with S.B. 697 and submitted to the Office of Statewide Health
Planning and Development; summaries of the plan are published in Community Hospital
publications and the local newspaper, and complete copies are available to any interested party.
Applications in the form of letter proposals are accepted at any time and are reviewed as
received. Grant decisions are made by the hospital’s President’s Administrative Committee.
Prospective applicants are encouraged to call to discuss the hospital’s potential interest in the
project or send a brief letter proposal to:
Cynthia L. Peck, Vice President, Community Hospital of the Monterey Peninsula
P.O. Box HH, Monterey, California 93942
(831) 625-4528
(831) 625-4948 fax
Letter proposals should include:
•
•
•
•
•
•
•
•
Name and brief description of the organization applying for the grant
Summary description and timeline of the proposed project or program
Amount requested and specific purpose of the grant
Total cost of the proposed project or program
Identification of any organizations collaborating on the proposed project or program
Relevance of the project or program to the mission of Community Hospital and our Community
Benefit Program
Statement that the organization is, and will remain so for the duration of the program for which
the grant is being sought, in full compliance with Community Hospital’s non-discrimination
policy as described above.
Tax identification number
B-2
•
•
Applicable Internal Revenue Code section (for example 501(c)(3))
Name, address, and telephone number of contact person who can provide additional information
if needed.
B-3
Appendix C. Community Benefit Collaborators
Business Organizations
AT&T Pebble Beach National Pro-Am
Carmel Valley Manor
Curves Health Club
Del Mesa Carmel, Adult Community
Del Monte Shopping Center
Fenton & Keller Law Firm
HealthCPA
Hyatt Hotels & Resorts
In-Shape Health Club
Laguna Seca Raceway
Macy’s Monterey
McClatchy-Tribune News Service
Monterey County Business Council
Monterey County Herald
Monterey County Weekly
Pebble Beach Company
Safe Sitter, Inc.
Safeway Supermarkets
SaveMart Supermarkets
Tanimura & Antle
Community Groups
Alliance on Aging
Big Sur International Marathon
Blind and Visually Impaired Center
Boys and Girls Clubs of Monterey
County
Boy Scouts of America
Carmel Foundation
Child Abuse Prevention Council
Community of Caring, Monterey
Peninsula
Community Partnership for Youth
Every 15 Minutes
First 5 of Monterey County
Health Projects Center
Hope Services
Hospice Foundation
Junior League, Monterey Chapter
Kiwanis Club, Salinas
Monterey Bay Christian Church
Monterey Jazz Festival
Monterey Museum of Art
Monterey Peninsula Foundation
Monterey Rape Crisis Center
Monterey Yacht Club
My Museum
Rancho Cielo Youth Campus
Salinas Women's Crisis Center
United Way of Monterey County
C-1
Educational Organizations
Health-Related Organizations
Alisal Union School District
All Saints’ Day School
Cabrillo College Foundation
Cabrillo Community College
California State University, Monterey
Bay
California State University, Sacramento
Carmel High School
Carmel Unified School District
Defense Language Institute
Greenfield Unified School District
Hartnell College
Heald College
Junior Wings, Nanao, Japan
Lyceum of Monterey County
Marina High School
Maurine Church Coburn School of
Nursing
Mission Trails, ROP
Monterey Adult School
Monterey Bay Aquarium
Monterey County Office of Education
Monterey High School
Monterey Peninsula College
Monterey Peninsula College Foundation
Monterey Peninsula Unified School
District
Mount St. Mary’s College
Naval Postgraduate School
Ohlone College
Pacific Grove High School
Pacific Grove Unified School District
Rocky Mountain University
Salinas Adult School
Salinas City Elementary School District
Samuel Merritt College
Seaside High School
University of California, San Francisco
University of the Pacific
University of Southern California
University of Vermont
Upward Bound Program, Monterey
Peninsula College
Academy of Nutrition and Dietetics
Alzheimer’s Association
American Bone Health
American Cancer Society
American Diabetes Association
American Heart Association
American Medical Response
American Red Cross
American Stroke Association
Arthritis Foundation
Bayer Diagnostics
Big Sur Health Clinic
California Transplant Donor Network
Clinica de Salud del Valle de Salinas
Compassionate Care Alliance
Dominican Hospital
Good Life Home Care
Hazel Hawkins Hospital
Healthy Mothers, Healthy
Babies Coalition
Insulet Corporation
Juvenile Diabetes Research Foundation
Mead Johnson Nutritionals
Monterey County Medical Society
Monterey Heart Symposium
National Hospice and Palliative Care
Organization
Natividad Medical Center
Ordway Pharmacy
Roche Diagnostics
Salinas Valley Memorial Hospital
Stroke Awareness Foundation
Sunrise Care Center
UCSF Helen Diller Family
Comprehensive Cancer Center
United Ostomy Associations of America
Walgreen’s Pharmacy
Watsonville Community Hospital
Windsor Care Center
C-1
C-2
Public Agencies
California Division of Forestry
Cal Fire – CA Dept. of Forestry and Fire
Protection
California Highway Patrol
California Telephone Access Program
Carmel Regional Fire Department
City of Marina
City of Monterey
City of Seaside
Department of Veterans Affairs
Hospital Preparedness Program
Monterey County Department of
Housing
Monterey County Department of Social
and Employment Services
Monterey County District Attorney’s
Office
Monterey County Emergency Medical
Services Agency
Monterey County Employment
Development Department
Monterey County Health Department
Monterey County Police Athletic League
Monterey County Sheriff’s Office
Monterey County WIC Program
Monterey County Regional Fire
Department
Monterey Police and Fire Departments
Monterey-Salinas Transit District
New Monterey Senior Center,
City of Monterey
Oldemeyer Center, City of Seaside
Workforce Investment Board
C-1
C-3
Appendix D. Alphabetical Master List
Title of Service
A Conversation with Life program
Description of Service
An information and discussion program on the personal, practical, medical, and spiritual aspects of
end-of-life preparation. Learn what to do to prepare, and how best to communicate healthcare
wishes to family and medical team, before being unable to speak for yourself.
Advanced weight-loss surgery support group
A support group for individuals who have already undergone weight-loss surgery at least 12
months prior to program involvement.
Help for Recovery Center patients and families to avoid recurrences of drug abuse and stay drugfree.
Biweekly support group to provide families of patients with Alzheimer's disease with information,
education, and support.
Provide appropriate aromatherapy applications, therapeutic quality essential oils, and equipment to
enhance comfort and quality of life for patients, families, and caregivers.
Education and support program encouraging self-sufficiency of participants.
Registered nurse volunteers (CHOMP and non-CHOMP) to staff medical tents throughout the
tournament and provide first-aid supplies.
Education and support program for adults with attention difficulties focused on identifying attention
difficulties and developing strategies to improve concentration, planning, and organizing.
Presentations regarding the medical aspects of sleep apnea and sleep disorders.
Part-time nurse coordinating all pre-hospital provider activities for Community Hospital and
Monterey County.
Program of individual and group support for coping with death-related grief.
Physician and nurse support and medical supplies for race events.
Aftercare support groups/continuing care groups
Alzheimer's family support group
Aromatherapy
Arthritis support group
AT&T Pebble Beach National Pro-AM
Tournament
Attention issues 101: for adults
AWAKE support group
Base Hospital Coordinator
Bereavement program
Big Sur Half and International Marathonsmedical support
Billing support services for patients
Blood Center volunteer services
Service helps support patients with complex medical conditions through reading, understanding,
and paying health bills from multiple providers.
Volunteers assist clinical staff on mobile sites and in the Blood Center.
D-1
Title of Service
Body mechanics applied to nursing
Bone Health Lecture Series
Breast cancer early support
Breastfeeding: the beginning
Cabrillo College radiologic technologist class
California Transplant Donor Network program
Cancer Care Symposium
Cancer Survivor's Day
Cancer Wellness support group
Caregiver connection
Caregiver’s support group
Children’s supplies in CHOMP waiting areas
Chronic pain support group
Collaboration with area schools, colleges and
community groups
Community benefit grants
Community substance abuse lectures and
presentations
Depression/bipolar support group
Diabetes support group
Discharge binders
Donation of electronic materials
Donations to community events
Electronic greeting cards
Emergency preparedness
Class for first-year nursing students on proper body mechanics in patient care.
Lecture series for the public on bone health.
An education and support group for women with early diagnosis of breast cancer.
Class to get breastfeeding off to a good start, prevent problem, and focus on the role of nutrition.
Training program at community college for radiologic technologists.
Program that provides organs from deceased patients to the California Transport Donor Network.
Symposium for clinicians and community members addressing the risks, benefits, and alternatives
to cancer screening and improving clinical practices of diagnostic evaluation and treatment.
Picnic luncheon/program for cancer survivors and families at Monterey County Fairgrounds.
Weekly support group for any person with cancer and their support person(s).
Provides support, resources, and coping strategies to caregivers of patients at end-of-life.
Provides support, information, and self-care for family, friends, and caregivers of cancer patients.
Incentives given to employees to encourage them not drive to work alone. Free employee shuttle
between CHOMP and area cities.
Distribution of children's supplies (crayons, coloring books, toys, etc.) to Emergency department
and other waiting rooms and public areas throughout the hospital.
Ongoing support group teaching coping skills to people with chronic pain.
Collaboration, consultation with area schools, colleges and community groups to review drug
policies, education & "best practices" to address substance abuse issues.
Community benefit grants to nonprofit organizations and multi-agency collaborative organizations
in support of health assessment and improvement projects within the hospital's service area.
Education of general public on variety of mental health/substance abuse topics.
Provide additional supportive care for patients.
Group for those with type 1 and type 2 diabetes focused on living the day-to-day challenges and
conflicts of self-management.
Binders containing patients' medical information and post-discharge follow-up instructions for use in
managing their care in the community setting.
Disposal of electronic waste.
Medications donated to the Big Sur International Marathon, the AT&T golf tournament, and Carmel
Unified School District 24-hour relay.
Print and distribute electronic greeting cards for patients that arrive via e-mail from the CHOMP
web site.
Collaboration with the Monterey County EMS agency to develop an updated, comprehensive
emergency preparedness plan and a community awareness campaign.
D-2
Title of Service
Epilepsy support group
Every 15 Minutes
Family Birth Center tour
Family/patient education and counseling
Food donations to community
Free Emergency department medical records
Free prescriptions for needy patients
General charity care (at cost)
Griefbusters
Grieving the loss of a child
Hand sanitizer distribution
Healing art retreat
Healthcare career fair
Health fair - Educational & Diabetes Nutrition
Services
Health fair - Labor of Love
Health fair – Men’s Wellness Night
Health fair – Mental Health & Substance Abuse
Health information series-Knowledge Is Power
Health information series-Poetry in Motion
Health news sponsorship
Health resource library
Heart Smart supermarket tour
HIV/AIDS care
Hospice patient support services
Hospital call center
Hospital and community service
Hospital on the Hill
Informal group setting that offers mutual support and information for those living with the
challenges of epilepsy, their family, and friends.
Drunk driving prevention program for local high schools.
Orientation and tour of the Family Birth Center for parents-to-be.
Education and counseling for families and patients regarding cancer issues.
Donation of food for community events.
Free copies of Emergency department medical records.
Underwriting the cost of discharge/outpatient prescriptions for those unable to pay.
Hospital services for patients in financial need.
Children's bereavement program offered through schools.
Support group for parents who have lost a child through accident or illness.
Distribute hand sanitizer free to the public (0.5-oz bottles) throughout the hospital.
A six-hour art therapy program for people with cancer and their support persons.
Introduce high school students to nursing and allied health careers.
Health fair providing information to the public on health issues as well as blood pressure, blood
sugar, and cholesterol screening.
Health fair providing information about pregnancy and pregnancy services at CHOMP.
A prostate cancer screening event and men’s health fair aimed at high-risk males who have not
had a screening for prostate cancer in the past.
Health fairs providing information to the public on mental health and substance abuse issues and
other problems.
Free monthly workshops on health topics such as heart disease, cancer, and arthritis.
Free monthly lectures on orthopedic health topics.
Sponsored airing of health news segments on KION and KSBW TV.
Free health library for the public including computer searches and referrals.
Tours of local supermarkets with instruction on healthy foods and how to read food labels to avoid
unhealthy foods.
HIV education, testing, and counseling; clinical care throughout full spectrum of the disease.
Volunteer respite and psychosocial support for hospice patients' caregivers and families.
Call center provides continuous customer service for information regarding hospital classes,
support groups, and services.
Leadership and participation in community organizations.
A narrated video is presented by Auxiliary volunteers to kindergarten students at Monterey
Peninsula elementary schools to expose students to hospital procedures and equipment.
D-3
Title of Service
Hospital tours
In-home blood collection
Internships for marriage and family therapists
Internships for physical therapy students
Internships in health information technology
Kids Eat Right
Legs for Life Screening
Live longer, live stronger
Look Good, Feel Better
Materials Management donation of supplies
Mental health information and referral service
Mindfulness Meditation
Monterey County Community Health Centers
Monterey County Science Fair - Judge
Mood management class
Mood management support group
Negative margin services
“On Nutrition” weekly newspaper column
Ostomy support group
Parent support group
Tours provided by Auxiliary volunteers to schools and professional groups interested in hospital
operations.
Phlebotomist sent to homes and skilled nursing facilities to collect blood samples for nonambulatory patients.
Internships offering MFT students an opportunity for volunteer hours needed to complete their
course work.
Free 4-12 week internships for in- and out-patient rehabilitation settings.
Provide internships for students in information technology in a health care environment.
After-school program at local elementary schools that includes education, food preparation, and
physical activity.
Free screening for peripheral vascular disease (PVD), a common circulatory condition associated
with leg pain, aching, and/or cramping that comes on with exercise.
Cancer survivorship program addressing the physical, psychological, social, financial, and spiritual
issue that survivors confront.
Class for cancer patients covering practical techniques for wearing wigs and scarves and using
makeup to enhance appearance during treatment.
Donation of miscellaneous medical supplies and equipment to charitable organizations.
Phone intake for new patient appointments, information, and referrals to appropriate mental health
services and community resources.
An 8-week course which consists of intensive training in mindfulness meditation, gentle movement,
and group support.
Community Hospital representative serves on board of directors for Monterey County Community
Health Centers.
Judge Monterey County high school students' science projects at Monterey County-wide event.
A class to help you understand the connection between thoughts and emotions and learn practical
ways of managing change.
Ongoing group for Recovery Center patients who are diagnosed with an adjustment, mood, or
anxiety disorder.
Subsidized cost of services for Outpatient Immunology Services and Blood Center.
Weekly column discussing nutrition published in The Monterey County Herald.
Education and support for people who have had or will have ostomy surgery, their family members,
and friends.
Education and support for parents of adolescents who are struggling with drug or alcohol abuse
and behavior problems.
D-4
Title of Service
Patient navigator training
Patient transportation
Peninsula Health Information Link
Peninsula Primary Care
Physician recruitment program
Prostate support group
Public Access Defibrillator Project (AED)
Public Speaking: Review of medication issues
and pharmacy careers
Pulse magazine
Recovery Center alumni association
Recovery Center assessment program
Restless Leg Syndrome support group
Safe Sitter course
Scholarship program
School and youth group field trips
Sewing committee
Sexual Assault Response Team
Share the care
Speaker's Bureau
Stroke support group
T’ai chi for health
Telecare service
Trained volunteers who are matched with cancer patients and their supporters to assist them in
navigating through the challenges of cancer.
Free transportation to medical appointments within the community for chronically and terminally ill
patients.
Subsidize the purchase of ambulatory electronic medical record systems to encourage physician
adoption of technology in their offices.
Two clinics (one in Carmel and one in Marina) provide primary care services.
Recruit and retain local physicians for critically needed medical specialties.
Monthly support group for men with prostate cancer.
Donation of automated external defibrillators to public sites on the Monterey Peninsula.
Speaker at various groups to review medication issues related to various conditions, services and
careers.
Free publication containing practical health and wellness information on a variety of topics for the
lay audience.
Weekly meeting/support activity for Recovery Center alumni.
Free assessment interview/consultation for substance abuse disorders, mental health, and dual
disorder treatment..
A support group for individuals who suffer from restless legs and/or periodic limb movement
disorder.
Babysitting course for children 11-13 years old including instruction on safety, child development,
and ethics of babysitting.
Program providing need-based scholarships for students pursuing healthcare careers, both
undergraduate and graduate.
Familiarize youth with the hospital to relieve anxiety about hospital visits and to provide exposure to
healthcare careers.
Annual volunteer activity to make sewing projects for newborns and inpatients during the holiday
season.
Training of new nurses for Sexual Assault Response Team (SART); maintenance of training
equipment for the SART teams.
Community non-profit organizing group to support development of care teams for individuals and
their families experiencing life-limiting illnesses.
Bureau providing expert speakers on a variety of medical and healthy industry topics to community
groups free of charge.
Support and information for stroke survivors and their families.
Basic t'ai chi orientation and movements for people of all abilities.
A daily reassurance telephone call to house-bound community residents.
D-5
Title of Service
Time to talk: with veterans and their loved ones
Topics in Diabetes
Total joint replacement class
Transitions
Tutorial education program
United Way employee campaign
Unpaid cost of CHAMPUS
Unpaid cost of Medi-cal
Unpaid cost of Medicare
Volunteer hours served by hospital trustees
Walk and Win
Web site
Weigh of Life class
Weigh of Life II support group
Weight-loss surgery nutrition class
Weight-loss surgery support group
Weight-loss surgery: back on track support group
Weight-loss surgery banding support group
Women's cancer support group
Women's Forum for Health
Workforce Investment Board
Workforce Readiness Initiative
Discussion about issues, struggles, and successes related to serving in the military.
A monthly education group for people wanting more information on diabetes.
Class offered to total joint replacement patients on expected hospital course, exercises, equipment
and procedures, and pain management.
Provides case management and volunteer services to clients suffering from life threatening illness
with a prognosis of 12 months or less.
Program providing academic classes for students un-served by special education department.
Employee participation in the United Way campaign to raise funds for local nonprofit organizations.
Unpaid cost of care for patients covered by CHAMPUS program.
Unpaid cost of care for patients covered by Medi-Cal program.
Unpaid cost of care for patients covered by Medicare program.
Members of the organization’s Board of Trustees serve in a volunteer capacity on the board and on
numerous committees.
Class series on beginning an exercise program.
Free health information offered via web site.
Class providing information on the immune system, basic nutrition, food safety, and food
supplements.
Weight management support group for men and women.
Class on post-gastric bypass nutrition and eating.
Support and information group for anyone who has undergone gastric bypass surgery, has plans to
undergo the surgery in the future, or is contemplating the procedure.
Lecture series with a variety of topics designed to help people better obtain and maintain their
weight-loss goals after surgery.
Providing peer-to-peer support to those with adjustable gastric bands, with professional guidance
and education.
A bi-weekly support group for women facing issues associated with a cancer diagnosis.
A lecture to promote health education, awareness, and partnerships among local women.
Volunteer service in healthcare advisory roundtable workforce assessment committee.
Hospital employee serves as Monterey Peninsula Chamber of Commerce education committee
chairperson promoting workforce readiness initiatives for all levels of education in our community.
D-6

2012 community benefit plan - Community Hospital of the Monterey

Transcription

Similar documents

THEDROPBOXFILM.ca

Catholic Community Center

San Benito High School District

bargetto winery

Downtown Strathroy 4:00 - 9:00pm Sponsored by

Equine Anhidrosis research project flyer

2012 PN Archivist Tasting Notes

Calendar Of Caring - The Salvation Army Monterey Peninsula Corps

Cannery Row - Elizabeth Hansen

January 29, 2015 Rotary Herald Page